他汀类药物对血液透析患者微炎症及促红细胞生成素低反应性的影响

目的探讨他汀类药物对维持性血液透析患者微炎症状态及促红细胞生成素低反应性的影响。方法286例行维持性血液透析患者中应用他汀类药物治疗者68例为治疗组，未应用他汀类药物治疗者218例为对照组。比较2组治疗前、后血清高敏C反应蛋白、血清铁蛋白、血红蛋白水平及每周促红细胞生成素用量。结果治疗组血清高敏C反应蛋白治疗后（1．23±1．11）mg／L较治疗前（1．58±1．49）mg／L降低（P〈0．05），对照组治疗前（1．93±1．22）mg／L与治疗后（2．10±1．77）mg／L比较差异无统计学意义（P〉0．05）；治疗组平均每周促红细胞生成素用量（30．60±24．50）u／kg明显低于对照组（47．30±31．20）u／kg（P（0．05），且促红细胞生成素反应指数（2．82±1．73）低于对照组（4．51±3．48），差异有统计学意义（P〈O．05）；多元逐步回归分析显示，性别、hs-CRP、透析时间、血清铁蛋白及他汀类药物治疗是促红细胞生成素反应指数的独立影响因子。结论他汀类药物可改善维持性血液透析患者微炎症状态，并减少患者促红细胞生成素的用量。

Effect of statin on microinflammation and erythropoietin responsiveness index in maintenance hemodialysis patients

Objective To investigate the effect of statin on microinflammation and erythropoietin responsiveness index in patients undergoing maintenance hemodialysis. Methods A total of 286 patients undergoing maintenance hemodialysis were divided into treatment group （n-68） receiving statins and control group （n-218） not receiving statin. The levels of high sensitivity C-reactive protein, serum ferritin and hemoglobin, and the prescribed erythropoietin- stimulating agent dose were compared between two groups. Results The level of high sensitivity C-reactive protein was （1.23 ± 1.11）mg/L after treatment, significantly lower than that before treatment （1.58 ± 1.49） mg/L in the treatment group （P〈0.05）. There was no significant difference in control group after treatment（2.01±1.77）mg/L compared withthat belore treatment （1.93±1.22） （P〉0.05）. l heprescrbed erythropoletln-stlmulatmgagent dose was （30. 6±24.5） IU/kg every week, significant lower than that in control group （47. 304±31.20）IU/kg every week（P〈0.05）, and the erythropoietin response index was lower in the treatment group （2.82±1.73） than that in control group （4.51±3.48） （P% O. 05）. Stepwise multiple regression analysis showed gender, high sensitivity C-reactive protein, duration of hemodialysis, serum ferritin and statin use were independent determinants of the erythropoietin response index. Conclusion Statin treatment leads to lower miroinflammation and reduces the dosage of erythropoietin stimulating agents.